Hip replacement arthroplasty has become widely accepted and has been remarkably successful as a procedure for relieving pain and restoring motion in patients suffering from disabilities resulting from various hip arthropathy. Generally, conversion endoprosthesis or total hip replacement prosthesis is often indicated for hip arthropathies involving the femoral side. For example, hip prosthesis is indicated in cases of degenerative joint disease from various causes, rhumatoid arthritis, and traumatic arthritis.
As part of total hip replacement surgery, the hip joint must be dislocated, and the femoral head must be lifted out of the acetabulum and brought out of the deep wound for further preparation and implant procedures. For example, the femoral neck must be transected, the medullary canal must be opened along the transected neck using a reamer or hollow chisel, and the medullary canal must be plugged. Thereafter, the medullary canal is cleaned and irrigated, there is a trial fitting of the femoral prosthesis, and femoral cement is filled and compressed within the medullary canal. Thereafter, the femoral stem is inserted and properly fitted in place. Because of the plug within the medullary canal and the compression of the cement, the force needed to insert the stem is relatively high, and pressure must be maintained until the cement is completely hardened. Throughout all of these procedures, the femur and the femoral neck must be manipulated and supported substantially outside of the deep wound. Heretofore, various bone retractors and femoral elevators available in the industry have been utilized to accomplish the support and manipulation of the femur required. Such bone retractors and femoral elevators previously available often required manipulative interaction with soft tissue adjacent the femur or femoral neck being manipulated and supported. In order to accomplish that manipulation and support, these devices generally depended upon leverage gained by support from those adjacent soft tissue structures. As a result, the soft tissue was often subjected to undue trauma and/or injury during these surgical procedures, and support provided by these instruments was inconsistent and unreliable.
For example, the self-retaining bone retractor shown in U.S. Pat. No. 2,695,607, which issued to H. Hipps et al., on Nov. 30, 1954, clearly shows the direct compression of soft tissue adjacent the bone and incision, and further contemplates utilization of a flexible connector wrapped around the external portions of that same soft tissue. Similar bone retractors are often utilized to manipulate and elevate the femur during hip replacement surgical procedures. Obviously, it is preferred during any surgical procedure to minimize undue trauma and injury whenever possible. The compressive forces imposed upon the soft tissue adjacent the bone as a result of utilizing the Hipps et al. bone retractor has heretofore been an undesirable necessity.
Another form of retractor commonly available in the industry and often used in hip replacement surgical procedures is the femoral neck elevator such as available from the Richards Medical Company of Memphis, Tenn. (e.g. Cat. No. 11-9674). Such femoral neck elevator, however, similarly relies on surrounding soft tissue for leverage in order to manipulate and support the femur and/or femoral neck. Its generally curved and multi-toothed bone rest portion also permits unpredictable slippage of the femur during manipulation and support procedures, making this instrument harder to work with. Consequently, while these instruments have been specifically designed for use in elevating the femur during hip replacement surgical procedures, their use fails to provide reliable support and can cause additional and often unnecessary trauma and/or injury to the surrounding soft tissue. While the overall damage of this additional trauma and/or injury may be outweighed by the overall benefit of the surgery to the patient, it would be preferable to provide an instrument which could minimize this undue trauma and injury while providing dependable and convenient femoral support and manipulation.